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The ACA Just Keeps Getting More and More Popular

A new poll concludes the law’s favorability ratings are at record highs.

By Dwyer Gunn

Earlier today, the Kaiser Family Foundation, which has been tracking the popularity of the Affordable Care Act since 2010, announced that 48 percent of those surveyed now view the law favorably, compared with 42 percent who view it unfavorably. That 48 percent is, as a KFF press release points out, “the highest level of favorability measured in more than 60 Kaiser Health Tracking Polls conducted since 2010.” KFF attributes the shift to an increase in the number of independent voters who approve of the law.

(Chart: Kaiser Family Foundation)

As the chart to the left illustrates, the public remains divided over whether, and how, the ACA should be repealed, with 48 percent of participants opposed to repeal, and 47 percent in favor.

Forty-eight percent of poll respondents, meanwhile, said they were worried that “they or someone in their family will lose their health insurance if the law is repealed and replaced.” The poll also found that approximately two-thirds of participants favor retaining Medicaid’s current funding structure, as opposed to converting it to a block-grant or per-capita funding formula. The vast majority of respondents (84 percent) also viewed it as “very” or “somewhat” important to maintain federal Medicaid funding for states that expanded the program under the ACA.

“Such concerns about reduced Medicaid funding likely reflect the public’s personal experiences with the program with nearly six in 10 (56%) reporting some connection with the Medicaid program, either because they personally have received some assistance from Medicaid (26%) or they have close friends or family who have (31%),” the press release concluded.

The poll results come on the heels of another interesting KFF issue brief, released earlier this week, that asked Donald Trump voters with ACA coverage what they’d like to see in a replacement plan. The brief details the findings of Jennifer Tolbert and Larisa Antonisse, two Kaiser researchers who conducted a number of focus groups in December with Trump voters in Michigan, Ohio, and Pennsylvania, all of whom were covered through either the ACA’s Medicaid expansions or the ACA’s marketplaces. Participants in those focus groups wanted more affordable premiums, more help for “people like them” (i.e. more generous subsidies for the middle class), lower out-of-pocket costs, broader provider networks, and greater transparency about plan coverage and medical costs. The focus group participants were unanimously opposed to the individual mandate, but most liked the pre-existing condition requirements in the law and called for more government regulation of insurance and pharmaceutical companies.

The focus group participants weren’t fond of the high-deductible health plan/Health Savings Account combination, which is favored by the GOP and features prominently in most ACA replacement plans. “When asked to react to aspects of several elements of Republican ACA replacement proposals that would provide consumers with access to high deductible plans coupled with HSAs, participants were highly concerned that the deductibles would be unaffordable and cause people to avoid seeking needed care, ultimately resulting in poorer health outcomes nationally,” Tolbert and Antonisse write. “They did not consider a high deductible plan to be ‘real insurance.’”

Some participants even called for a single-payer health-care system. “I want what Obama actually promised when he first got elected. I actually was a proponent of socialized medicine,” said a Trump voter in Harrisburg, Pennsylvania. “Canada has it. Europe has it…. I don’t think anybody in America should have to choose between eating, paying their mortgage, and getting health care. So I think it should be a right for every American citizen.”

None of the current Republican ACA replacement plans call for more generous subsidies, lower deductibles, single-payer health-care systems, or the “public option”—the latter of which has been the subject of much Democratic lobbying.